The Olde Coach House is a residential care home that provides support and accommodation for up to 33 people, some of whom may be living with dementia. On the day of the inspection there were 32 people living at the home. There are various lounge areas where people can spend their time and a large dining room. Bedrooms are located on the ground and first floors and seven bedrooms have en-suite facilities. The home is close to shops, transport routes and other local amenities. The service is also registered to provide care and support from the same location for people who live in their own home. When we inspected this service approximately 35 people were receiving a service at home.

At the last inspection, the service was rated Good and at this inspection we found the service remained Good.

People told us they were happy living at the home and that they felt safe. Risks were appropriately managed.

Medicine had been managed safely for the majority of people. However, we found some minor anomalies in the records that were addressed on the day, after our discussion with the registered manager.

Fire safety and evacuation procedures were in place and systems to record accidents and incidents. We noted that on one occasion we felt staff should have sought medical attention in a more timely manner. We discussed this with the registered manager and they advised that they would discuss with the appropriate staff member. This appeared to be an isolated incident.

Staff were aware of people’s individual support needs and this enabled

them to provide person-centred care. Many activities were provided in the home to give people the opportunity for meaningful occupation.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff received induction training when they were new in post and on-going training that was considered to be essential by the home.

People told us they enjoyed the meals provided by the home and we saw that people’s nutritional needs were met.

Quality assurance systems were robust and identified shortfalls in the service that were acted upon. People told us both the home and the home care service were well managed.

People had various opportunities to give feedback about the service they received. They felt their concerns and complaints were listened to.

Further information is in the detailed findings below.

The Olde Coach House is a care home in Hessle, East Yorkshire. It is registered for 33 people and offers support to older people and people living with dementia. On 2 October 2014 the provider added the regulated activity of personal care (Domiciliary) to their registration. At the time of this inspection the domiciliary part of their registration was dormant.

This inspection was unannounced and took place on 22 January 2015. We previously visited the service on 3 December 2013 and found that the registered provider met the regulations we inspected.

At the time of our inspection there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us that they felt safe living at the home. Staff had completed training on safeguarding adults from abuse and were able to describe to us the action they would take if they had concerns about someone’s safety. They told us that staff responded to them quickly and knew and understood their needs. The care we observed throughout our visit demonstrated a real person centred ethos.

The provider had safe and effective processes in place to look after people’s personal allowances. Individual records of all transactions were kept, with receipts.

Staff understood individual risks to people and worked with them to minimise these risks whilst also supporting them to remain as independent as possible.

We saw that there were sufficient numbers of staff on duty to meet the needs of people who lived at the home. New staff had been employed following the home’s recruitment and selection policies to ensure that only people considered suitable to work with vulnerable people had been employed.

Medicines were administered safely by staff and the arrangements for ordering, storage and recording were robust.

All of the people living at The Olde Coach House spoke highly of staff and we observed warm friendly relationships between people living and working at the home. It was a family environment which was very much evident throughout our visit. Recruitment systems were robust and appropriate checks were completed before people started work.

The provider had employed skilled staff and took steps to make sure the care was based on local and national best practice. Individual staff had taken on special roles, such as ‘champions’ to make sure that best practice was followed by all staff in the service.

People who used the service, relatives and health care professionals described the service as outstanding and said that the registered manager and staff went above and beyond expectations to ensure people had things which were important to them.

Staff were appropriately trained and skilled and provided care in a safe environment. They all received a thorough induction when they started work at the service and fully understood their roles and responsibilities, as well as the values and philosophy of the service. The staff had also completed extensive training to make sure that the care provided to people who used the service was safe and effective to meet their needs.

People were supported to make their own decisions and when they were not able to do so, meetings were held to ensure that decisions were made in the person’s best interests. If it was considered that people were being deprived of their liberty, the correct documentation was in place to confirm this had been authorised.

There was a strong emphasis on the importance of eating and drinking well. People’s nutritional needs had been assessed and people told us that meals provided by the home were excellent. People were supported appropriately by staff to eat and drink safely.

Throughout our inspection we saw examples of creative care that helped make the service a place where people felt included and consulted. People were involved in the planning of their care and were treated with dignity, privacy and respect. People told us that staff were caring and compassionate and this was supported by the relatives and health / social care professionals who we spoke with.

People who lived at the home, relatives and staff told us that the home was well managed. The quality audits undertaken by the registered manager were designed to identify any areas of concern or areas that were unsafe, and there were systems in place to ensure that lessons were learned from any issues identified. It was evident throughout our visit that people living there remained at the heart of everything staff did. The registered manager’s continual presence in the service demonstrated that they ‘led by example.’ This was also confirmed by staff during our visit.

People told us that staff respected their choices, they also said they felt their needs were being met. One person said “I can’t complain at all”. One relative said “I am happy with the care my relative receives.” A health professional told us that staff always followed their instructions; they said “Staff are really good here.”

We found that people’s records included some evidence that they had given their consent, for example with the handling of their medication. The manager told us how they were developing record keeping in this area.

People were supported though a computerised system of care planning which recorded assessments of needs and daily records. Staff were knowledgeable on how to support people and had received training, for example in dementia care needs.

We saw that mealtimes were unrushed and relaxed with people receiving support to have their nutritional needs met.

Systems were in place to support people with their medication needs, these had recently been reviewed and updated.

There was a quality assurance system in the home which included audits of different areas of care by the manager to help ensure that people’s needs were met.

People told us that staff were polite and respected them. They said staff knocked on their bedroom doors prior to entering. People told us that they felt their needs were met in the home and that they felt safe.

We saw that people's records included their likes and dislikes with staff being able to give us good examples of the choices people had each day.

People were supported in having their needs met through a computerised care planning system which covered a variety of areas. People had access to other health professionals to ensure that their needs were met. A visiting professional told us that they felt the home met people's needs.

Staff were aware of and had received training in the safeguarding of vulnerable people and there were systems in place to support people with their finances.

Staff were effectively recruited and received some training. However a number of training courses required completing to ensure that the continued to have their needs met.

There was a complaints system within the home and although not on display people who lived in the home and their relatives were aware of how to complain and felt able to raise any issues.

People we spoke with were complimentary about the care they received at the home. People told us there are many activities available and the staff ensured that if people wished to be involved, they could be. People told us their rooms were kept clean, their privacy respected and the food was good with plenty of variety.